Head Start: Challenges Faced in Demonstrating Program Results and
Responding to Societal Changes (Testimony, 06/09/98, GAO/T-HEHS-98-183).

Pursuant to a congressional request, GAO discussed its work on the Head
Start program, focusing on: (1) how well the Department of Health and
Human Services (HHS) ensures that the Head Start program is achieving
its purpose; and (2) how well Head Start is structured to meet the needs
of program participants in today's social context, which differs
significantly from that of 30 years ago.

GAO noted that: (1) Head Start has, through the years, provided a
comprehensive array of services and, as envisioned by the Government
Performance and Results Act, has in recent years substantially
strengthened its emphasis on determining the results of those services;
(2) its processes still provide too little information, however, about
how well the program is achieving its intended purposes; (3) HHS has
developed a performance assessment framework that effectively links
program activities with the program's overall strategic mission and
goal; (4) this framework also includes measurable objectives for how the
program will be implemented and what outcomes will be achieved; (5) HHS
has new initiatives that will, in the next few years, provide
information not previously available on outcomes such as gains made by
children and their families while in the program; (6) currently,
however, these initiatives are limited to assessing outcomes at the
national level, not at the local agency level; (7) in addition, GAO is
not convinced that these initiatives will provide definite information
on impact, that is, whether children and their families would have
achieved these gains without participating in Head Start; (8) although
obtaining this kind of impact information would be difficult, the
significance of Head Start and the sizeable investment in it warrant
conducting studies that will provide answers to questions about whether
the program is making a difference; (9) in addition to questions about
the program's impact, questions exist about whether Head Start is
structured to meet the needs of today's participants who live in a
society much changed since the mid-1960s when the program was created;
(10) families' needs have changed as more parents are working full time
either by choice or necessity; (11) in addition, children and their
families can now receive services similar to Head Start's from a growing
number of other programs; (12) these social trends raise questions about
how well Head Start is structured to meet participants' needs and, if
changes are needed, what those changes should be; and (13) a lack of
information about the array of community programs available and about
actions local Head Start agencies have already taken hinders
decisionmakers' ability to respond to these trends.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-98-183
     TITLE:  Head Start: Challenges Faced in Demonstrating Program 
             Results and Responding to Societal Changes
      DATE:  06/09/98
   SUBJECT:  Preschool education
             Program evaluation
             Preschoolers
             Disadvantaged persons
             Data collection
             Child care programs
             State-administered programs
IDENTIFIER:  Head Start Program
             HHS Temporary Assistance for Needy Families Program
             HHS Family and Child Experiences Survey
             
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Cover
================================================================ COVER


Before the Subcommittee on Early Childhood, Youth and Families,
Committee on Education and the Workforce, House of Representatives

For Release on Delivery
Expected at 10:00 a.m.
Tuesday, June 9, 1998

HEAD START - CHALLENGES FACED IN
DEMONSTRATING PROGRAM RESULTS AND
RESPONDING TO SOCIETAL CHANGES

Statement of Carlotta C.  Joyner, Director
Education and Employment Issues
Health, Education, and Human Services Division

GAO/T-HEHS-98-183

GAO/HEHS-98-183T


(104929)


Abbreviations
=============================================================== ABBREV

  ACF - Administration for Children and Families
  FACES - Family and Child Experiences Survey
  HHS - Department of Health and Human Services
  TANF - Temporary Assistance for Needy Families

HEAD START:  CHALLENGES FACED IN
DEMONSTRATING PROGRAM RESULTS AND
RESPONDING TO SOCIETAL CHANGES
============================================================ Chapter 0

Mr.  Chairman and Members of the Subcommittee: 

I am pleased to be here today to discuss our work on the Head Start
program.  The 30-year-old Head Start is widely viewed as one of the
most successful social programs of our time.  Head Start's ultimate
goal, or program purpose, is to improve the social competence of
children in low-income families.  Critical to achieving this goal,
according to Head Start, are enhancing children's growth and
development and strengthening their families.  Built on a philosophy
that emphasizes the benefits of a comprehensive, interdisciplinary
program, Head Start has provided funding for a broad set of
educational, medical, mental health, and social services to
low-income preschool children and their families.  Especially during
Head Start's early years, it provided services that participants
probably would not otherwise have received.  Administered by the
Department of Health and Human Services (HHS), Head Start has served
over 16 million children at a total cost of more than $38 billion. 
Annual funding for the program has grown substantially in recent
years--from $1.5 billion to almost $4 billion between fiscal years
1990 and 1997--and the program is currently poised for a major
expansion.  The administration's goal now is to expand the program's
annual enrollment to one million children by 2002. 

This proposed program expansion, combined with the current
reexamination of Head Start's underlying legislation as well as the
demand for results-oriented programs called for by the Government
Performance and Results Act of 1993 (Results Act), offer a timely
occasion for considering the two major issues that my statement
addresses today:  (1) How well does HHS ensure that the Head Start
program is achieving its purpose?  (2) How well is Head Start
structured to meet the needs of program participants in today's
social context, which differs significantly from that of 30 years
ago? 

My statement is based primarily on information from two of our recent
Head Start reports.  One report provided descriptive information\1 on
the program that we obtained in part from surveying local Head Start
agencies; the other reviewed the research literature on the impact of
Head Start.\2 My statement is also based on the preliminary results
from an ongoing study that we are conducting at your request on how
HHS ensures that Head Start programs are accountable for complying
with laws and regulations and for achieving program purposes. 
"Achieving program purposes" refers to (1) whether the Head Start
program has achieved outcomes such as differences in Head Start
participants' growth and development and (2) whether the program has
an impact.  We define impact as differences in outcomes, such as
improved school readiness or health status, caused by Head Start
participation.  Implicit in this definition is that differences in
outcomes would not have occurred without program participation.\3

In summary, Head Start has, through the years, provided a
comprehensive array of services and, as envisioned by the Results
Act, has in recent years substantially strengthened its emphasis on
determining the results of those services.  Its processes still
provide too little information, however, about how well the program
is achieving its intended purposes.  HHS has developed a performance
assessment framework that effectively links program activities with
the program's overall strategic mission and goal.  This framework
also includes measurable objectives for how the program will be
implemented and what outcomes will be achieved.  HHS has new
initiatives that will, in the next few years, provide information not
previously available on outcomes such as gains made by children and
their families while in the program.  Currently, however, these
initiatives are limited to assessing outcomes at the national level,
not at the local agency level.  In addition, we are not convinced
that these initiatives will provide definitive information on impact,
that is, on whether children and their families would have achieved
these gains without participating in Head Start.  Although obtaining
this kind of impact information would be difficult, the significance
of Head Start and the sizeable investment in it warrant conducting
studies that will provide answers to questions about whether the
program is making a difference. 

In addition to questions about the program's impact, questions exist
about whether Head Start is structured to meet the needs of today's
participants who live in a society much changed since the mid-1960s
when the program was created.  Families' needs have changed as more
parents are working full time either by choice or necessity.  In
addition, children and their families can now receive services
similar to Head Start's from a growing number of other programs. 
These social trends raise questions about how well Head Start is
structured to meet participants' needs and, if changes are needed,
what those changes should be.  For example, the predominantly
part-day, part-year structure of Head Start programs may not be as
suited to meeting the participants' needs as it was in the past. 
Moreover, a lack of information about the array of community programs
available and about actions local Head Start agencies have already
taken hinders decisionmakers' ability to respond to these trends. 


--------------------
\1 For our descriptive study, we surveyed all regular Head Start
programs, and we obtained responses from 86 percent of them.  By
"regular" Head Start, we mean programs that operate within the scope
of established Head Start program options and under normal Head Start
requirements.  These are distinguished from demonstration and other
special programs, which may serve populations or offer services not
normally found in Head Start.  Regular Head Start serves 85 percent
of the children in Head Start. 

\2 Head Start Programs:  Participant Characteristics, Services, and
Funding (GAO/HEHS-98-65, Mar.  31, 1998) and Head Start:  Research
Provides Little Information on Impact of Current Program
(GAO/HEHS-97-59, Apr.  15, 1997). 

\3 See Head Start:  Research Insufficient to Assess Program Impact
(GAO/T-HEHS, 98-126, Mar.  26, 1998). 


   BACKGROUND
---------------------------------------------------------- Chapter 0:1

Head Start was created in 1965 as part of President Johnson's War on
Poverty.  It was built on the premise that effective intervention in
the lives of children can be best accomplished through family and
community involvement.  Fundamental to this notion was that
communities should be given considerable latitude to develop their
own Head Start programs.  Head Start's primary goal is to improve the
social competence of children in low-income families.  Social
competence is the child's everyday effectiveness in dealing with both
the present environment and later responsibilities in school and
life.  Because social competence involves the interrelatedness of
cognitive and intellectual developmental, physical and mental health,
nutritional needs, and other factors, Head Start programs provide a
broad range of services.  Another essential part of every program is
parental involvement in parent education, program planning, and
operating activities. 

Head Start is administered by HHS' Administration for Children and
Families (ACF), which includes the Head Start Bureau--one of several
under ACF.  Agencies that deliver Head Start services at the local
level may be either grantees or delegate agencies.  Unlike some other
federal social service programs that are funded through the states,
HHS awards Head Start grants directly to local grantees.  Grantees
numbered about 1,460 in fiscal year 1997.  They may contract with
organizations--called delegate agencies--in the community to run all
or part of their local Head Start programs.  Grantees and delegate
agencies include public and private school systems, community action
agencies and other private nonprofit organizations, local government
agencies (primarily cities and counties), and Indian tribes. 

HHS distributes Head Start funds by using a complex formula that is
based upon, among other things, previous allotments and the number of
children, aged 5 and under, below the poverty line in each state
compared with the number in other states.  Head Start is a federal
matching grant program, and grantees typically must contribute 20
percent of program costs from nonfederal funds.  These funds can be
cash, such as state, county, and private money, or in-kind
contributions such as building space and equipment.  The average
amount of funds available per child in Head Start programs in the
1996-97 program year was $5,186;\4 an average of $4,637\5 of this
amount came from Head Start grant funds.  Total funds per child
varied widely by program, however, ranging from $1,081 to $17,029 per
child.  Before using Head Start funds for services, local agencies
are required by Head Start regulations to identify, secure, and use
community resources to provide services to children and their
families.  Consequently, Head Start programs have established many
agreements for services. 

Head Start targets children from poor families, and regulations
require that at least 90 percent of the children enrolled in each
local agency program be low income.  As shown in figure 1, Head Start
families are poor as indicated by several measures.  During the
1996-97 program year, more than one-half of the heads of Head Start
households were either unemployed or worked part time or seasonally,
and about 60 percent had family incomes under $9,000 per year. 
Furthermore, only 5 percent had incomes that exceeded official
poverty guidelines, and 46 percent received Temporary Assistance for
Needy Families (TANF)\6 benefits. 

   Figure 1:  Employment and
   Income Status of Head Start
   Families

   (See figure in printed
   edition.)

Source:  Head Start's 1996-97 survey. 

Head Start is authorized to serve children at any age before the age
of compulsory school attendance; however, most children enter the
program at age 4.  In the 1996-97 program year, most children were
either 3 (31 percent) or 4 (63 percent) years old (see fig.  2). 
They also shared other similar demographic characteristics.  Most of
the children--79 percent--
spoke English as their main language.  Spanish-speaking children
constituted the next largest language group--18 percent.  About 38
percent of the children were black, 33 percent were white, and 25
percent were Hispanic.  About 13 percent of Head Start children had
some sort of disability. 

   Figure 2:  Age, Ethnicity, and
   Dominant Language of Head Start
   Children

   (See figure in printed
   edition.)

\a Regular Head Start, which excludes Early Head Start and Migrant
programs (which serve a number of children in this age group), also
serves children who are under 3 years old--as well as children who
are 6.  However, both groups represent less than 1 percent of the
total. 

\b Other includes children who are Asian or Pacific Islanders and
American Indian or Alaska Native. 

\c Other includes children whose dominant language is an Asian,
Native American, or other language. 

Source:  Head Start's 1996-97 survey. 


--------------------
\4 Total funding per child was calculated by dividing the funding
from all sources, including Head Start grant funds, by total funded
enrollment. 

\5 Average Head Start grant funding per child was calculated by
dividing Head Start grant funds by Head Start-funded enrollment. 

\6 TANF, enacted in 1996, replaced the Aid to Families With Dependent
Children program. 


   HEAD START INITIATIVES REFLECT
   INCREASED FOCUS ON RESULTS, BUT
   STILL PROVIDE TOO LITTLE
   INFORMATION ABOUT WHETHER
   PROGRAM MAKES A DIFFERENCE
---------------------------------------------------------- Chapter 0:2

The Congress has recently acted to strengthen Head Start's emphasis
on achieving program purposes by, for example, requiring the program
to develop performance measures.  In reauthorizing the Head Start Act
in 1994,\7 the Congress required HHS to develop specific performance
measures for Head Start so that program outcomes could be determined. 
This requirement is consistent with the Results Act, which seeks to
shift the focus of federal management away from inputs and processes
and toward outcomes.  Under the Results Act, agencies are required to
develop goals and performance measures that will be assessed annually
to show progress toward reaching the goals.  Agencies are also
expected to conduct specific evaluation studies as needed to obtain
additional information about what federal programs are achieving. 

In response to this emphasis on performance assessment, Head Start
has developed a framework that links program activities of local Head
Start grantees to the program's overall strategic mission and goal. 
This framework emphasizes the importance not only of complying with
statutes and regulations, but also of achieving demonstrable
outcomes.  Head Start has developed five measurable,
performance-based objectives.  Two of these focus on outcomes:  (1)
enhancing children's growth and development and (2) strengthening
families as the primary nurturers of their children.  The other three
focus on program activities that the agency believes are critical to
achieving the two outcome objectives:  (1) providing children with
educational, health, and nutritional services; (2) linking children
and families to needed community services; and (3) ensuring
well-managed programs that involve parents in decision-making. 

Overall, HHS has a methodologically and conceptually sound approach
to assessing outcomes.  HHS developed multiple performance measures
to use in assessing progress in meeting these objectives.  For each
measure, HHS has established one or more performance indicators by
which to track the percentage of change.  Because data on many of
these indicators were not previously available, HHS has designed
initiatives to collect the data.  Head Start intends to assess
progress toward these goals mainly through the Family and Child
Experiences Survey (FACES).  This survey will collect data from
families with children enrolled in a random sample of Head Start
centers (3,200 families were selected when the survey began in fall
1997), assessing them on a wide range of characteristics at the
beginning of program participation, at the end of each year they
participate, and at the end of kindergarten.  Thus, Head Start will
know, for example, if participants' physical health and emergent
literacy and math and language skills have improved. 

The FACES survey, however, will collect information only at the
national level.  At the local level, HHS does not require individual
Head Start agencies to demonstrate that they have achieved program
outcomes.  They are only held accountable for achieving the
objectives linked specifically to activities, such as providing a
developmentally appropriate educational environment.  HHS officials
told us, however, that they intend in the future to require local
agencies to assess what outcomes they have achieved, as some agencies
already do.  HHS has no specific plan or timetable yet for when this
transition will take place. 

In addition, these HHS initiatives will not address the need for
information on Head Start's impact, limiting its ability to assess
how well the program is achieving its purpose.  That is, the
initiatives will not explain what caused any improved
outcomes--whether the same outcomes would have occurred if children
and families were in other kinds of early childhood programs or none
at all.  Although we acknowledge the difficulty of conducting impact
studies of programs such as Head Start, we believe that research
could be done that would assure the Congress and HHS that the current
$4 billion federal investment in Head Start is achieving its purpose. 

Head Start has described its FACES initiative as useful for drawing
conclusions about impact as well as outcomes, but we believe a more
rigorous research design is needed.  HHS officials have told us, for
example, that the FACES results can be used to determine program
impact because each time the performance of Head Start participants
is assessed it will be compared with the "norm" or typical
performance of some other group of children on the same test. 
Although this approach has some merit, it also has many limitations. 
For example, if the group of children used to establish the norms is
unlike the children in Head Start, conclusions about program impact
will be unclear.  The most reliable way to determine program impact
is to compare a group of Head Start participants with an equivalent
group of nonparticipants.  Comparable groups of participants are
important to determining impact because they prevent mistakenly
attributing outcomes to program effects when these outcomes are
really caused by other factors.  For instance, a recent evaluation of
the Comprehensive Child Development Program,\8 a demonstration
project involving comprehensive early childhood services like those
of Head Start, found positive changes in the families participating. 
Because the study could compare participants with a comparable group
not in the program, however, researchers discovered that families
that had not participated also had similar positive changes.  They
concluded, therefore, that the positive changes could not be
attributed to the program.  Because of the importance of being able
to attribute outcomes to Head Start rather than to other experiences
children and their families might have had, we recommended in our
1997 report\9 that HHS include in its research plan an assessment of
the impact of regular Head Start programs. 


--------------------
\7 P.L.  103-252. 

\8 National Impact Evaluation of the Comprehensive Child Development
Program, Abt Associates (Cambridge, Mass.:  June 1997). 

\9 GAO/HEHS-97-59, Apr.  15, 1997. 


   CHANGED SOCIAL ENVIRONMENT
   RAISES QUESTIONS ABOUT HEAD
   START'S ROLE
---------------------------------------------------------- Chapter 0:3

Head Start operates in a social environment that differs greatly from
that of 30 years ago when the program was established:  more parents
are working full time, either by choice or necessity, and many more
social service programs exist to address the needs of disadvantaged
children and their families.  These circumstances raise policy
questions relevant to any consideration of the Head Start program's
future. 


      PREDOMINANTLY PART-DAY,
      PART-YEAR HEAD START
      PROGRAMS MAY NOT BE MEETING
      THE NEEDS OF TODAY'S
      FAMILIES
-------------------------------------------------------- Chapter 0:3.1

The need for early education and child care beyond the home has
increased dramatically in the last 20 years due to changes in family
structure, women's employment, and the demand for preschool
education.\10 The proportion of children under age 6 who live with
only one parent has increased.  Due partly to the growing proportion
of single mothers, the number of those with children under 6 who work
outside the home has also increased dramatically.  Welfare reform
legislation, passed in 1996, may further intensify families' need for
full-day, full-year education and child care services.  Under TANF,
which was created by the 1996 legislation, states must place 25
percent of adults receiving TANF benefits in work and work-related
activities in fiscal year 1997 to avoid financial penalties.  The
required participation rate rises to 50 percent in fiscal year 2002. 
Head Start's own data show that about 38 percent of Head Start
families needed full-day, full-year child care services in 1997. 
About 44 percent of the families that needed full-day, full-year
child care services left their children at a relative's or unrelated
adult's home when the children were not in Head Start. 

Because Head Start is predominantly a part-day, part-year program,
the full-day needs of families conflict with the way program services
have traditionally been delivered.  In program year 1996-97, most
Head Start children (90 percent) attended programs at group centers,
rather than in home settings;\11 about half of them (51 percent)
attended centers that operated 3 to 4 hours per day.  Only 7 percent
of the children attended centers that operated 8 or more hours a day
(see fig.  3).  Almost two-thirds of the children attended centers
that operated 9 months of the year; only one-fourth (27 percent) of
the children attended centers that operated 10 to 11 months.  And
even fewer--7 percent--attended centers that operated year round. 

   Figure 3:  Most Children Attend
   Part-Day, Part-Year Programs

   (See figure in printed
   edition.)

Note:  For this figure, programs operating 8 hours per day or more
are considered full day. 

Source:  GAO survey. 

Program officials have been asking themselves fundamental questions
about how they will operate in an environment in which more parents
are working, according to our research.  For example, a New York City
Head Start official described a critical dilemma:  Do we serve more
children for fewer hours or fewer children for more hours?  Given the
large number of unserved children in New York City, serving fewer
children was considered unwise and impractical.  On the other hand,
if the program continued to serve children in part-day programs, it
would not be meeting needs of many children who need full-day
services.  This program has also received anecdotal reports of
families who have left Head Start programs because their hours of
service are insufficient to meet families' needs.  According to the
director of a program in Ohio, this part-day Head Start program was
"out of sync" with the needs of families who need longer hours of
care for their children.  The director stated that the need for
part-day services is "evaporating."

Other aspects of the program may also conflict with the priorities of
working parents.  For example, Head Start's emphasis on strong
parental involvement, its requirement that staff visit children's
homes, and its home-based service delivery option may be more
difficult to implement given the schedules of working parents.  Head
Start program officials told us that welfare reform was already
seriously affecting their programs' makeup.  For example, a Head
Start director in Montana reported that the program eliminated some
of the home-based slots so that more children could attend centers. 
According to a Head Start director in Pennsylvania, the changed
environment presents considerable obstacles to the home-based
program.  This program will try to accommodate families' schedules
and perhaps conduct home visits in the evening, but the director
acknowledged that sometime in the future home visits may no longer be
feasible. 

In 1997, the Congress appropriated additional funds to, among other
things, increase local Head Start enrollment by about 50,000
children.  The Head Start Bureau's priorities for allocating these
funds differed from those of the past.  In the past, priorities for
allocating funds to expand Head Start emphasized part-day, part-year,
or home-based services.  In recognition of the increasing proportion
of Head Start families needing full-day programs for their children,
however, the Head Start Bureau announced that programs providing more
full-day, full-year Head Start services will receive special priority
for the new funds.  Head Start has urged local agencies to consider
combining these new Head Start expansion funds with other child care
and early childhood funding sources and to deliver services through
partnerships, such as community-based child care centers.  According
to HHS officials, this shift in emphasis was responsible for the fact
that more than 30,000 of the 36,000 new enrollment opportunities for
3- to 5-year-olds will be for full-day, full-year Head Start. 


--------------------
\10 A Profile of Child Care Settings:  Early Education and Care in
the 1990s, Volume 1, Contract No.  LC88090001, Mathematica Policy
Research, Inc.  (Princeton, N.J.:  1991), p.  1. 

\11 Head Start has three approved program options:  (1) children
receive most services in a center but some home visits are required,
(2) children receive most services in their home with some
opportunities to interact in a group setting, and (3) children
receive services that combine center attendance with home visits. 
Local agencies may also get approval for a locally designed option
such as family day care homes. 


      ADDITIONAL COMMUNITY
      PROGRAMS SUPPLEMENT SERVICES
      AVAILABLE THROUGH HEAD START
-------------------------------------------------------- Chapter 0:3.2

Other federal, state, and local programs as well as private
organizations now provide more services for disadvantaged children
and their families than in the past.  As a result, the role of local
Head Start agencies has evolved from providing services directly to
helping participants obtain services.  Local agencies, in fact, are
required to identify, secure, and use community resources in
providing services to Head Start children before using Head Start
funds for these services.  As figure 4 shows, Head Start often
facilitates its participants' access to services, such as
immunizations, rather than provide them directly.  For example, when
we asked Head Start programs the main methods used to provide medical
services for enrolled children, 73 percent of survey respondents said
that they referred participants to services, and some other entity or
program, such as Medicaid's Early and Periodic Screening, Diagnosis,
and Treatment Program, primarily paid for the services.  Dental
services were also mainly provided by entities other than Head Start
programs. 

   Figure 4:  Head Start's Role in
   Providing Many Services Is
   Facilitating Access

   (See figure in printed
   edition.)

Note:  Head Start programs deliver services in a variety of ways. 
This figure highlights the most direct and indirect ways Head Start
programs deliver services. 

Source:  GAO survey. 

Although the number of other programs that provide educational
services has also grown in the past 30 years, education is the one
service that local Head Start agencies typically provide by
delivering it directly rather than facilitating access to it from
another source.  Some Head Start program officials who contracted
with private preschools or child care centers to provide education
services described the arrangement as offering benefits to both Head
Start and the other program.  For example, the arrangement eliminated
the need to find a facility for the Head Start program as well as to
provide the facility startup costs.  The private center benefited
from the arrangement as well because the Head Start funds allowed the
center to do some repair work and purchase computers and playground
equipment.  We do not know the numbers of community programs that may
provide education services, their capacity, or the overall quality of
these programs.  Head Start programs reported, however, that an array
of early childhood programs operate in their communities and serve
Head Start-eligible children.  For example, 70 percent of Head Start
program respondents reported to us that their area had state-funded
preschools; 90 percent had other preschools and child development and
child care centers in their area; and 71 percent reported that family
day care homes served Head Start-eligible children in their area. 

Just as Head Start is not the only community program providing
specific services to disadvantaged children and their families, it is
also not the only program that uses a community's network of services
to facilitate access to a comprehensive set of services.  In a 1995
report (which used 1990 data from a nationally representative sample
of early childhood centers),\12 we concluded that most disadvantaged
children did not receive a full range of services from early
childhood centers in part because of the limited number that could be
served and limited subsidies and in part because of such centers'
limited missions.  More recent evidence, however, suggests growth in
the availability of such services for children.  HHS has no
information about the number of community programs providing
comprehensive services, nor did we obtain this information in our
recent study; we plan to explore this further in another study. 

We do know, however, that some programs other than Head Start that
serve disadvantaged children also help children and families obtain
additional services such as medical and social services.  For
example, the Head Start grantees responding to our survey in some
cases also operated other early childhood programs for disadvantaged
children.  We found that about 11 percent of the local Head Start
agencies served some children who were eligible for Head Start
through other early childhood programs.  (Respondents reported
serving about 14,000 such children in program year 1996-97.) These
children received some or most--but not all--of the services
typically provided to children in Head Start programs.  These
programs were more likely to provide education services, meals,
social services, and immunizations; dental and medical services were
least often provided.  In addition, some states offer preschool
programs that emulate Head Start's comprehensive model.  In fact,
some states provide services that are seemingly identical to those
provided through Head Start.  For example, in 1993, Georgia initiated
its first statewide prekindergarten program.  The program coordinates
services for families, and children receive basic health and dental
screenings and meals.  In addition, Ohio has a state-funded Head
Start initiative that coordinates closely with the federal Head Start
program.  The state-funded initiative offers children services that
are identical to Head Start's.  In addition, Ohio has a state-
funded preschool program for disadvantaged children that operates
according to Head Start performance standards. 


--------------------
\12 Early Childhood Centers:  Services to Prepare Children for School
Often Limited (GAO/HEHS-95-21, Mar.  21, 1995). 


      LACK OF INFORMATION HINDERS
      DECISIONMAKERS' RESPONSE TO
      SOCIAL TRENDS
-------------------------------------------------------- Chapter 0:3.3

While recognizing that these social changes may significantly affect
Head Start now and in the future, the Congress and Head Start lack
information needed to decide what specific actions to take in
response to them.  Information is lacking about families' needs for
services, how well Head Start's current structure can respond to
those needs, and the array of options available to disadvantaged
children and their families.  For example, although we expect the
need for full-day services to grow, we do not know the extent to
which families will choose Head Start--a predominantly part-day
educational program--over full-day programs that offer child care,
even if the Head Start program has an arrangement with another
provider for child care for the rest of the day.  Moreover, evidence
suggests that more states, for example, are investing in child care
and prekindergarten initiatives.  The number of such initiatives is
not known, however, nor do we have information on their quality.  In
addition, only limited anecdotal information exists about Head Start
agencies' initiatives for responding to these trends and the success
of those initiatives.  Additional information on family service needs
and the options available to them would be valuable to Head Start and
the Congress in ensuring that the significant investment of federal
dollars is used to the greatest advantage to improve the social
competence of children in low-income families. 


-------------------------------------------------------- Chapter 0:3.4

Mr.  Chairman, this concludes my statement.  I would be happy to
answer any questions you or members of the Subcommittee may have. 


*** End of document. ***